Maligniteyi taklit eden pulmoner arteriyovenöz malformasyon: Olgu sunumu

Pulmonary arteriovenous malformations (AVM) are congenital lesions and are often arise in the lower lobes due to abnormal capillary development. Forty-two years old male patient presented with hemoptysis and he was referred to our clinic with the suspicion of malignancy. Postero-anterior chest roentgenogram revealed homogenous opacity on the right perihilar zone. Computed tomography revealed a mass which was located at the right upper lobe. For the dia gnosis and staging 18F-FDG PET- CT was obtained. The mass was 6.5x5x4.5 cm and showed increased FDG uptake, 2,97. The lesion was considered as a large PAVM because of the linear density showing luminal contrast enhancement which was located between the lesion and right upper pulmonary vein. Dynamic contrast enhaced tomography revealed a solid mass with a suspicion of PAVM with thrombotic occlusion. Pulmonary angiography was free of AVM and fistulae. The patient underwent right upper lobectomy. Pathologic studies were consistent with pulmonary AVM. This case is presented because of upper lobe involvement, normal pulmonary angiography and the need of surgical operation as the only diagnostic tool

Evaluation of patients with fibrotic interstitial lung disease: Preliminary results from the Turk-UIP study

OBJECTIVE: Differential diagnosis of idiopathic pulmonary fibrosis (IPF) is important among fibrotic interstitial lung diseases (ILD). This study aimed to evaluate the rate of IPF in patients with fibrotic ILD and to determine the clinical-laboratory features of patients with and without IPF that would provide the differential diagnosis of IPF. MATERIAL AND METHODS: The study included the patients with the usual interstitial pneumonia (UIP) pattern or possible UIP pattern on thorax high-resolution computed tomography, and/or UIP pattern, probable UIP or possible UIP pattern at lung biopsy according to the 2011 ATS/ERSARS/ALAT guidelines. Demographics and clinical and radiological data of the patients were recorded. All data recorded by researchers was evaluated by radiology and the clinical decision board. RESULTS: A total of 336 patients (253 men, 83 women, age 65.8 +/- 9.0 years) were evaluated. Of the patients with sufficient data for diag-nosis (n=300), the diagnosis was IPF in 121 (40.3%), unclassified idiopathic interstitial pneumonia in 50 (16.7%), combined pulmonary fibrosis and emphysema (CPFE) in 40 (13.3%), and lung involvement of connective tissue disease (CTD) in 16 (5.3%). When 29 patients with definite IPF features were added to the patients with CPFE, the total number of IPF patients reached 150 (50%). Rate of male sex (p<0.001), smoking history (p<0.001), and the presence of clubbing (p=0.001) were significantly high in patients with IPE None of the women <50 years and none of the men <50 years of age without a smoking history were diagnosed with IPE Presence of at least 1 of the symptoms suggestive of CTD, erythrocyte sedimentation rate (ESR), and antinuclear antibody (FANA) positivity rates were significantly higher in the non-IPF group (p<0.001, p=0.029, p=0.009, respectively). CONCLUSION: The rate of IPF among patients with fibrotic ILD was 50%. In the differential diagnosis of IPF, sex, smoking habits, and the presence of clubbing are important. The presence of symptoms related to CTD, ESR elevation, and EANA positivity reduce the likelihood of IPF

Computed tomography findings of organizing pneumonia

Objective: In this study, we aimed to present computed tomography (CT) findings of 100 patients with histopathologically confirmed organizing pneumonia. Design: Retrospective study Setting: Ankara Atatürk Chest Diseases And Chest Surgery Training And Surgery Hospital, Ankara, Turkey Subjects: One hundred histopathologically confirmed organizing pneumonia patients between 2009 and 2013 admitted to our clinic. Intervention: A chest CT scan and the histopathological examination of the lung lesions of the patients were performed. Main outcome measure: The frequency and the types of CT findings of the patients with proven organizing pneumonia were examined. Results: Among 100 patients, 73 were male and 27 were female, and the mean age of the patients was 60±11 (range:19-90) years. Pulmonary consolidation was detected in 87 patients and ground-glass opacity was seen in 76 patients. Multiple nodules were seen in 20 patients while a solitary nodule was seen in 15 patients. Acinar nodular pattern was detected in 29 patients, micronodular pattern in 28 patients, bronchocentric pattern in 33 patients, perilobular pattern in 14 patients, progressive fibrotic pattern in 8 patients and reversed halo sign in 12 patients. Lymph node enlargement was seen in 80 patients. Conclusion: Computed tomography is very important for the diagnosis of organizing pneumonia which has various radiological findings. © 2022, Kuwait Medical Association. All rights reserved

Effect of Ovulation Induction on Ovarian Histologies in a Rat Model

OBJECTIVE: To examine the effect of human menopausal gonadotropin(HMG) and follitropinBeta (rFSH) on the ovarian histologies in a rat model. STUDY DESING:Thirty-nine female, one-year old rats were enrolled for the trial. They were divided into three groups. In the first group, 13 rats received, six cycles of ovulation induction with human menapausal gonadotropin.In the second group, 13 rats received six cycles of ovulation induction with folitropin beta the third study group consisted of 13 rats which received six cycles of saline intramuscularly. RESULT: The mean number of the cells that stained positive for Ki-67 was 42.3±20.6, 44.9±27.3and 42.5±24.8 in the folicles, respectively.The mean number of cells that stained positive for Ki-67 in epithelium was 0.15±0.42, 0.04±0.14,0.05±0.18, respectively. The mean dysplasiascore was 2.46±2.10, 1.69±13 and 1.62±1.89 in the ovarian epithelial cells respectively. CONCLUSION:Development of malignant lesion were not found in any of the rat ovaries after ovulation induction. As a result of this study, we found out that human menapausal gonodotropin and folitropin beta used in treatment of infertility, when administered for six cycles in accordence with the dosage determined, do not have the potential to develop neoplasia in rats

Türkiye’de akciğer kanserinde genetik mutasyonların bölgesel dağılımı (REDIGMA)

Introduction: The results of standard chemotherapy in lung cancer are not very satisfactory, so it is important to identify genetic mutations that provide targeted therapies. Recent reports have suggested influences of racial difference on the frequency of mutation in lung cancer. We aimed to determine the frequency and regional distribution of genetic mutations of non-small cell lung cancer (NSCLC) in Turkey. Materials and Methods: Regional distribution of genetic mutations in lung cancer in Turkey (REDIGMA) study was carried out as a prospective, cross-sectional, observational study in a large number of centers in which lung cancer patients were followed and could perform genetic mutation analysis on patients’ biopsy materials. Results: The 703 patients (77.7% male, mean age 63.3 ± 12.5 years) who were diagnosed as NSCLC from 25 different centers were included in the study. Tumor samples from patients were reported as 87.1% adenocarcinoma, 6.4% squamous cell carcinoma and 6.5% other. Mutation tests were found to be positive in 18.9% of these patients. The mutations were 69.9% EGFR, 26.3% ALK, 1.6% ROS and 2.2% PDL. Mutations were higher in women and non-smokers (p< 0.000, p< 0.001). Again, the frequency of mutations in adenocarcinoma was higher in metastatic disease. There was no difference between the patient’s age, area of residence, comorbidity and clinical stage and mutation frequency. Conclusion: Our study revealed that the EGFR mutation rate in Turkey with NSCLC was similar to East European, African–American and Caucasian patients, and was lower than in East Asia.Giriş: Akciğer kanserinde standart kemoterapinin sonuçları çok tatmin edici değildir, bu nedenle hedefe yönelik tedavileri sağlayan genetik mutasyonları belirlemek önemlidir. Son raporlar, ırksal farklılığın ve bölgesel değişikliğin akciğer kanserinde mutasyon sıklığı üzerindeki etkilerini göstermiştir. Çalışmamızda küçük hücreli dışı akciğer kanseri (KHDAK)'nde genetik mutasyonların Türkiye'deki sıklığını ve bölgesel dağılımını belirlemeyi amaçladık. Materyal ve Metod: Türkiye'de akciğer kanserinde genetik mutasyonların bölgesel dağılımı (REDIGMA) çalışması, akciğer kanseri hastalarının takip edildiği ve hastaların biyopsisinde genetik mutasyon analizi yapılabilecek çok sayıda merkezde prospektif, kesitsel ve gözlemsel bir çalışma olarak gerçekleştirildi. Bulgular: Çalışmaya 25 farklı merkezden KHDAK tanısı konan 703 hasta (%77.7 erkek, ortalama yaş 63.3 ± 12.5 yıl) alındı. Hastalardan alınan tümör örnekleri %87.1 adenokarsinom, %6.4 skuamöz hücreli karsinom ve %6.5 diğer olarak bildirildi. Mutasyon testleri bu hastaların %18.9'unda pozitif bulundu. Mutasyonlar %69.9 EGFR, %26.3 ALK, %1.6 ROS ve %2.2 PDL idi. Mutasyonlar kadınlarda ve sigara içmeyenlerde istatistiksel olarak daha yüksek tespit edildi (p< 0.000, p< 0.001). Yine, adenokarsinomdaki mutasyonların sıklığı metastatik hastalıkta daha yüksekti. Hastanın yaşı, ikamet alanı, komorbiditesi, klinik evresi ve mutasyon sıklığı arasında farklılık saptanmamıştır. Sonuç: Çalışmamızın sonucunda Türkiye geneli mutasyon pozitifliği literatür ile karşılaştırıldığında Türkiye’de KHDAK'lı hastalarda EGFR mutasyon oranının Doğu Avrupa, Afrikalı-Amerikalı ve Kafkasyalı hastalara benzer ve Doğu Asya'dan daha düşük olduğu ortaya koyulmuştu

Pulmonary involvement in inflammatory bowel disease

AIM: To determine the relationship of pulmonary abnormalities and bowel disease activity in inflammatory bowel disease (IBD)

Retrospective evaluation of patients with organizing pneumonia: is cryptogenic organizing pneumonia different from secondary organizing pneumonia?

Giriş: Organize pnömoni (OP) akciğer hastalıkları içerisinde nadir görülen klinik opatolojik bir durumdur. Gerçek insidansı ve prevalansı bilinmemektedir. Altta yatan hastalık ya da neden belli değilse kriptojenik organize pnömoni (KOP) olarak adlandırılır. Bu çalışmamızda son 10 yılda hastanemizde tanı alan organize pnömoni olgularının retrospektif olarak, etyolojik ve klinik özelliklerinin değerlendirilmesi ve kriptojenik ve sekonder OP hastalarının birbiri ile karşılaştırılması amaçlanmıştır.Materyal ve Metod: Bu çalışmaya Ağustos 2003-Ağustos 2013 tarihleri arasında patolojik doku tanısı OP gelen 165 hasta dahil edildi. Hasta bilgileri retrospektif olarak hastane dosyalarından incelendi.Bulgular: Çalışmaya patolojik olarak OP tanısı konulmuş 165 hasta dahil edildi. Hastaların 89 (%53.9)'una transtorasik ince iğne aspirasyon biyopsisi (TTİAB), 52 (%31.5)'sine cerrahi yöntemle (lobektomi, wedge rezeksiyon, segmentektomi), 24 (%14.5)' üne transbronşiyal biyopsi (TBB) ile tanı konulmuştu. 100 (%60.6) hastanın KOP, 65 (%39.4) hastanın da sekonder OP olduğu belirlendi. En yaygın görülen semptomlar; öksürük, halsizlik, dispne idi. Elli beş (%44.7) hastada restriktif, 26 (%21.2) hastada obstrüktif solunum fonksiyon bozukluğuna rastlandı. Çalışmamızda sekonder organize pnömoniye sebep olan bilinen etyolojik ajanlara ek olarak antrokozise ve kist hidatiğe bağlı olarak gelişen organize pnömoni olguları saptadık. Altmış dokuz hastada OP'un tipik radyolojik görünümü olan yamalı vasıfta bilateral multipl opasiteler, 76 hastada fokal lezyonlar (solid kitle, kaviter kitle), 6 hastada da infiltratif opasiteler izlendi.Sonuç: OP'un kriptojenik ve sekonder formlarında OP'a ilişkin klinik, radyolojik ve laboratuvar özellikler açısından fark yoktur. Ülkemizde sekonder OP tanısı konulan hastalarda, etyolojide kist hidatik ve antrokoziste akılda tutulmalıdır.Introduction: Organizing pneumonia (OP) is an uncommon clinic opathological situation among lung diseases. If no underlying cause can be detected, it is named as cryptogenic OP (COP). In this study, the etiologic and clinical characteristics of patients diagnosed as OP in our hospital in the last ten years were evaluated retrospectively. It was also aimed to make a comparison between COP and secondary OP patients. Materials and Methods: One hundred sixty-five patients diagnosed as OP pathologically in the 10 year period from August 2003 to August 2013 were included into that study. Patients' data were evaluated retrospectively from the medical records. Results: One hundred sixty five patients pathologically diagnosed as OP were included. Diagnostic methods were trans-thoracic fine-needle biopsy (TTFNB) in 89 (53.9%) patients, open lung biopsy (lobectomy, wedge resection, segmentectomy) in 52 (31.5%) patients and transbronchial biyopsy (TBB) in 24 (14.5%) patients. One hundred (60.6%) of the patients were defined as COP and 65 (39.4%) as secondary OP. Cough, fatigue and dyspnea were the most common symptoms on admission. We detected OP cases secondary to anthracosis and cyst hydatic besides other well known etiologies. In 61 patients, the main radiologic manifestation was multiple bilateral patchy consolidation typical for OP. In 76 patients focal lesions (solid mass, cavitating mass lesion) and in 6 patients infiltrative opacities were detected radiologically. Conclusion: There is no difference between properties of OP from clinical, laboratory and radiologic finding sin the criptogenic and seconder form of OP. Although it is not asserted, cyst hidatic and anthracosis could be kept in mind for the list of underlying ethiologies for secondary OP